Vicki A Deshazo

Primary specialty

AudiologistTaxonomy code 231H00000X

License

LD00002762 Issued in WA

Practice address

208 Bellevue Way NE
Bellevue, WA 98004-5720

Phone

(425) 455-5596

Fax

(425) 451-3248

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1811940349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BELLEVUE WAY NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045720",
            "telephone_number": "425-455-5596",
            "fax_number": "425-451-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BELLEVUE WAY NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045720",
            "telephone_number": "425-455-5596",
            "fax_number": "425-451-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHAZO",
        "first_name": "VICKI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD00002762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092881",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "8450512",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dermatopatholoty Northwest PLLC (Carlsen Histopath)
• Jessica Laura Deroche, LMT
• Eric Derovanessian, D.D.S
• Nicolaas Piet Deruyter, MD
• Arzu Dervish
• Aarti R Deshpande, M.D.
• Anna A Desimone, L.M.P.
• Bethany J. Desimone, ATC
• Desiree a. Fletcher DDS
• Marissa Despres

• Audiologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Audiologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.